Independent Review

Independent review is a plan-sponsored and/or state-mandated process for final administration review of a medical necessity determination for health care services provided to or proposed for patients.

As a URAC accredited Independent Review Organization (IRO), CLINIX is certified by individual states to conduct independent reviews. The IRO process is available if state law requires your health plan to participate or your plan voluntarily participates.

Usually, the IRO decision is binding.